Accuray Incorporated · NASDAQ:ARAY
Accuray — Investor Day (October 2021)
68 slides from Accuray's investor day presentation, Oct 25, 2021
Slide 1: Accuray Overview Video
1 Proprietary and Confidential Property of Accuray Accuray Overview Video Exhibit 99.1
Slide 2: Transforming Patient Care Through Innovation Investor Day
Accuray Transforming Patient Care Through Innovation Investor Day October 25, 2021
Slide 3: Agenda
Agenda 3 Proprietary and Confidential Property of Accuray
Slide 4: Safe Harbor Statement
Proprietary and Confidential Property of Accuray Safe Harbor Statement Statements in this presentation (including the oral commentary that accompanies it) that are not statements of historical fact are forward-looking statements and are subject to the “safe harbor” provisions of the Private Securiti
Slide 5: Our Vision: Expand the Curative Power of Radiation Therapy
5 Proprietary and Confidential Property of Accuray Our Vision: To EXPAND the CURATIVE POWER of RADIATION THERAPY to improve as many lives as possible Broader treatment options Beyond oncology Global patient access Enable advanced treatments Survival, long term outcomes Quality of life Precision tech
Slide 6: Entering the Golden Age of Radiotherapy
6 Entering the Golden Age of Radiotherapy Proprietary and Confidential Property of Accuray Accuray is leading the transformation 1 Versus 8 Week Treatments* Imaging Innovation Adaptive Therapy Partnerships Drug/Device Combination *SBRT treatments vs conventional fractionated treatments (5 sessions v
Slide 7: Accuray Systems: Differentiated Solutions
7 Accuray Systems: Differentiated Solutions Proprietary and Confidential Property of Accuray TomoTherapy® System Radixact® System Personalized Universal Fast S7™ System CyberKnife® 4D Dynamic Delivery Precise Speed Treatment Planning System Accuray Precision® Efficient Integrated Automated Ultimate
Slide 8: Strategy for Accelerating Revenue and Margin Expansion
8 Proprietary and Confidential Property of Accuray Strategy for Accelerating Revenue and Margin Expansion Financial model designed to both invest as well as grow the top line Reposition for Success Enhanced leadership Established China JV Introduced Synchrony® Improved cost structure and operating l
Slide 9: Long Term Growth Catalysts
9 Proprietary and Confidential Property of Accuray Long Term Growth Catalysts
Slide 10: Commercial Orders Momentum Entering FY22
10 Proprietary and Confidential Property of Accuray Commercial Orders Momentum Entering FY22 AMERICAS EMEA APAC +19% Q4 Y/Ya +39% Q1 Y/Yb WW MARKET +4.2%c CAGR 2021-2026 JAPAN a: Q4 FY21 orders Y/Y b: Q1 FY22 orders Y/Y. Q1 FY22 orders are preliminary unaudited results. c: MarketsAndMarkets RADIOTHE
Slide 11: Long Term Revenue Growth Catalysts
Long Term Revenue Growth Catalysts 11 Proprietary and Confidential Property of Accuray Technology Innovation Pipeline China Growth and Unique Business Model New Market Opportunities Acceleration of Favorable Market Trends
Slide 12: Robust Technology Pipeline
Robust Technology Pipeline 12 Proprietary and Confidential Property of Accuray Innovation Pipeline 15% of Revenue Invested in R&D* ClearRT™ CyberKnife® Online Adaptive Breast Package Radixact® VOLO™ Ultra Radixact® ClearRT™ Radixact® Neuro Package CyberKnife® Synchrony® Radixact® FY21-FY24 Launched
Slide 13: China Growth and Unique Business Model
13 Proprietary and Confidential Property of Accuray China Growth and Unique Business Model
Slide 14: China Joint Venture Business Progress
China Joint Venture Business Progress Proprietary and Confidential Property of Accuray 175 employees Commercial execution: Type-A: 85% market share* Type-B: Commercial coverage with JV product on-track Customer support team active with 30 systems installed in calendar 2021 World class training and e
Slide 15: China JV manufacturing ready for BIMT testing
15 Proprietary and Confidential Property of Accuray China JV manufacturing ready for BIMTa testing ISO 13485 certified Type-B product on track Planned market introduction in summer 2022 Anticipate shipments following NMPAb approval by end of CY2022 Sister manufacturing site development b NMPA: The N
Slide 16: New Market Opportunities
16 Proprietary and Confidential Property of Accuray New Market Opportunities
Slide 17: Expansion to Global Value Segment
Expansion to Global Value Segment Proprietary and Confidential Property of Accuray Upgradeability Path Reduced Total Cost of Care Expand Patient Access High Throughput and Quality Workflow Efficiency Differentiated Feature Set Base Clinical Capabilities with Options Mid-CY2023 Availability * Interna
Slide 18: NeuroRadiosurgery: Replacement Market Opportunity
NeuroRadiosurgery: Replacement Market Opportunity Proprietary and Confidential Property of Accuray *MarketsAndMarkets RADIOTHERAPY MARKET - GLOBAL FORECAST TO 2026 Gamma Knife is a registered trademark of Elekta AB (publ) Target neurosurgeons Treats brain AND spine Improved patient experience Synchr
Slide 19: Dr. David Roberge
19 Proprietary and Confidential Property of Accuray Dr. DAVID ROBERGE Adjunct Professor, Oncology McGill University, CHUM - Notre Dame
Slide 20: Market Trends and Technology Implications
20 Proprietary and Confidential Property of Accuray Market Trends and Technology Implications
Slide 21: Growing Use of Ultra-Hypofractionated Treatments
Growing Use of Ultra-Hypofractionated Treatments 21 Proprietary and Confidential Property of Accuray 52% Estimated Growth Since 2015 Number of patients *Medicare is subset of total treatments 2015 – 2019 Medicare Hospital Outpatient Standards Analytics File; 2015 – 2018 The Medicare Physician & Othe
Slide 22: COVID-19: Accelerates Hypofractionation Adoption
COVID-19: Accelerates Hypofractionation Adoption 22 Proprietary and Confidential Property of Accuray Increasing Clinical Evidence Guidelines Reduce the patient and provider risk of exposure
Slide 23: Aged Equipment Need Technology Upgrade
Aged Equipment Need Technology Upgrade Proprietary and Confidential Property of Accuray Conventional Ultra-HF Treat More Patients with Ultra-Hypofractionationb 40% U.S. Installed Base >9 yearsa a IMV 2019 Radiation Therapy Market Summary Report b Accuray internal data on file Installed base is aged
Slide 24: Prof. Raphael Moeckli
24 Proprietary and Confidential Property of Accuray PROF. RAPHAEL MOECKLI Group Leader, Medical Physicist at CHUV
Slide 25: Global leader in SRS/SBRT
25 Proprietary and Confidential Property of Accuray Global leader in SRS/SBRT Only robotic delivery system Fast <15 min treatments CYBERKNIFE® S7™ System 360-degree helical arc therapy IMRT and SBRT Fast <15 min treatments RRADIXACT® System Outstanding image quality Synchrony® 4D dynamic delivery VO
Slide 26: Clinical Evidence
26 Proprietary and Confidential Property of Accuray Clinical Evidence
Slide 27: PACE-B Prostate Study Shows Lower Side Effects with CyberKnife
~ 1 in 8 men in the U.S. will be diagnosed with prostate cancera First phase 3 trial testing 5-fraction SBRT for prostateb N=874 patients from 37 centers in 3 countriesb Subset analysis of the SBRT arm is favorable for the CyberKnife system PACE-B Prostate Study Shows Lower Side Effects with the Cyb
Slide 28: Dr. Alison Tree
28 Proprietary and Confidential Property of Accuray Dr. Alison Tree Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust
Slide 29: Accelerated Partial Breast Irradiation with the CyberKnife System
~ 1 in 8 women in the U.S. will develop invasive breast cancera 80% of all breast cancer treated are early stage, outcomes are excellentb Retrospective analysis and modeling of long-term risk of dying of secondary lung cancer Accelerated Partial Breast Irradiation Delivered with the CyberKnife® Syst
Slide 30: Head and Neck Cancer Delivered on the TomoTherapy System
Head and Neck Cancer Delivered on the TomoTherapy® System Proprietary and Confidential Property of Accuray 1 in 50 people affected by head and neck cancerb High mortality ratec N=166 patients with head and neck cancer, from 14 centersa TomoTherapy® compared with conventional linac showed better tumo
Slide 31: Pancreatic Cancer: Combination with Immunotherapy
Pancreatic Cancer: Combination with Immunotherapy Proprietary and Confidential Property of Accuray Pancreatic cancer survival is low, about 11%b N=170 patients randomized to CyberKnife® System SBRT plus immunotherapy vs. chemotherapya Excellent patient tolerancea Study shows increasing overall survi
Slide 32: Our Vision: Hope
32 Proprietary and Confidential Property of Accuray Our Vision: HOPE Non-Invasive Fast Enable Improved Outcomes Enable Quality of Life Comfortable Surgical Precision Expand the curative power of radiation therapy to improve as many lives as possible
Slide 33: The Accuray Product Difference
33 Proprietary and Confidential Property of Accuray The Accuray Product Difference
Slide 34: Radixact System
34 Proprietary and Confidential Property of Accuray Radixact® System Potential for improved outcomes and quality of life The Ultimate Full-body, Workhorse Radiation Therapy Device
Slide 35: Radixact System
35 Proprietary and Confidential Property of Accuray Radixact® System
Slide 36: The Radixact System: a Universal Workhorse
The Radixact® System: a Universal Workhorse Proprietary and Confidential Property of Accuray Synchrony® 4D Tumor Tracking w/ Dynamic Delivery Simple VOLO™ Ultra Planning Unique Helical Platform Any Case Complexity Precise Helical Dose Painting Diagnostic-like ClearRT™ Imaging Quick Installation Vend
Slide 37: ClearRT Helical kVCT Imaging
37 ClearRT™ Helical kVCT Imaging Proprietary and Confidential Property of Accuray Radixact® System’s unique helical platform advantages Planning Diagnostic-like quality Largest field of view (FOV) and scan length Fast 1-meter in 1-minute Upgradeable into the IB ADVANTAGES ClearRT™
Slide 38: The Competition: Conebeam CT comparison
38 Proprietary and Confidential Property of Accuray The Competition Conebeam CT comparison Conebeam CT Elekta OBI: ~ 60-120 sec Varian TrueBeam®: ~ 33-60 sec Varian Halcyon™: ~ 17-40 sec Slow Artifacts Non-uniformity Geometric distortion Limited Field of View ~ 20 cm maximum scan length <15 cm reduc
Slide 39: The Competition: Comparing to MR-Linac and conebeam CT
Excellent 39 Proprietary and Confidential Property of Accuray The Competition Comparing to typical MR-Linac and conebeam CT Good Poor
Slide 40: Dr. Lane Rosen, Willis-Knighton
40 Proprietary and Confidential Property of Accuray Dr. Lane Rosen Willis-Knighton
Slide 41: Clinical Challenge: Targets move
Clinical Challenge 41 Proprietary and Confidential Property of Accuray Targets move - Life is always in motion Methods of correcting for breathing, circulation, and digestion
Slide 42: Compensating for Movement
Proprietary and Confidential Property of Accuray Compensating for Movement ITV(internal target volume) healthy tissue receives a majority of the radiation dose Technique matters Synchrony® cancerous tissue receives a majority of the radiation dose 42 Enables dose escalation to the target Decreases r
Slide 43: Managing Breathing
43 Proprietary and Confidential Property of Accuray Managing Breathing Accuray does NOT require restrictive devices Trained Breathing Device: Enable Predictable Gating Patient Restraint: Abdominal Compression 1 of 3 Patients Typically Unable to Tolerate* *Davis CA, , oral presentation at ESTRO 2021,
Slide 44: Synchrony 4D Motion Tracking with Dynamic Delivery
Synchrony® 4D Motion Tracking with Dynamic Delivery 44 Proprietary and Confidential Property of Accuray Minimize Margins: Potential for improved outcomes, and enables ultra-hypofractionation Breath Naturally: Greater patient comfort, and a better experience Deliver Efficiently: Treat more patients,
Slide 45: Breast Cancer Solution Development
45 Proprietary and Confidential Property of Accuray Breast Cancer Solution Development C-RAD Catalyst+ HD Protect the heart Focus beam on the tumor/tumor bed Non-ionizing optical imaging patient setup Automated pause/resume specific to the needs of treating breast cancer patients Partnership with C-
Slide 46: Dr. Anand Mahadevan
46 Proprietary and Confidential Property of Accuray Dr. Anand Mahadevan Professor and Chairman of Radiation Oncology at Geisinger Health System
Slide 47: CyberKnife System
47 Proprietary and Confidential Property of Accuray CyberKnife® System Potential for improved outcomes and quality of life Dedicated Whole Body SRS/SBRT System
Slide 48: CyberKnife System
48 Proprietary and Confidential Property of Accuray CyberKnife® System
Slide 49: The CyberKnife Radiosurgery System
The CyberKnife® Radiosurgery System Proprietary and Confidential Property of Accuray Unique Robotic Platform Submillimeter Accuracy Fast Delivery Versatile SRS/SBRT System Thousands of Beam Angles Flexible Collimation For Various Cases Powerful Planning Choices Moving Or Stationary Targets
Slide 50: The CyberKnife System with RayStation
Latest generation RaySearch plan optimizer Protocols and scripting automation tools RayPhysics® enables seamless machine commissioning Highly intuitive workflows for which RayStation® is known The CyberKnife® System with RayStation® Planning Proprietary and Confidential Property of Accuray Partnersh
Slide 51: CyberKnife Neuro Radiosurgery System
51 Proprietary and Confidential Property of Accuray CyberKnife® Neuro Radiosurgery System Planned Partnership with Brainlab® Elements Neuro Pre-planning, and Quentry® Familiar to neurosurgeons; Supports clinical evidence generation via registry access Frameless and Frame Option* Expands treatment to
Slide 52: Dr. Aditya Gupta
52 Proprietary and Confidential Property of Accuray Dr. ADITYA GUPTA Chief Neurosurgeon at Artemis Hospital
Slide 53: Accuray Systems Have Vendor-Neutral OIS Connectivity
Accuray Systems Have Vendor-Neutral OIS Connectivity 53 Accuray Connectivity Proprietary and Confidential Property of Accuray iDMS® Radiation Oncology Department Closed a historical gap Seamless workflow: scheduling, image review, treatment capture Electronic medical record integration ensures a com
Slide 54: Innovation Continues
54 Proprietary and Confidential Property of Accuray Innovation Continues
Slide 55: ClearRT Imaging Critical Input to Adaptive Workflow
55 Proprietary and Confidential Property of Accuray ClearRT™ Imaging Critical Input to Adaptive Workflow Online adaptation is under development - This does not reflect a commitment to deliver products, software, features, functionality, or upgrades, and should not be relied upon in making purchasing
Slide 56: Strategic Exploration
Strategic Exploration 56 Proprietary and Confidential Property of Accuray Immunotherapy with RT for abscopal effect Automation “one-stop-shop” and daily adaptive RT The future of the CyberKnife® system beyond 3D imaging KOL THINK TANKS
Slide 57: Financial Update
57 Proprietary and Confidential Property of Accuray Financial Update
Slide 58: Key Financial Metrics
Key Financial Metricsa Proprietary and Confidential Property of Accuray ACTUALS Q4 FY21 Y/Y Q1 FY22 HIGHLIGHTS New product innovation driving order momentum Largest fiscal first quarter revenue number in Company history Raised FY22 full year revenue guidance to $420M to $427M Tightened FY22 full yea
Slide 59: Improved Q4 FY21 Balance Sheet for Future Growth
59 Proprietary and Confidential Property of Accuray Improved Q4 FY21 Balance Sheet for Future Growth Key parameters are strengthening based on actions taken Debt Restructuring Lowered Interest expense by ~$2.5M/year Greater flexibility with new term loan and revolver covenants Capacity to invest in
Slide 60: Strategy for Accelerating Revenue and Margin Expansion
60 Proprietary and Confidential Property of Accuray Strategy for Accelerating Revenue and Margin Expansion Financial model designed to both invest as well as grow the top line Reposition for Success Enhanced leadership team Established China joint-venture Introduced Synchrony Reset cost structure to
Slide 61: Closing Remarks
61 Proprietary and Confidential Property of Accuray Closing Remarks
Slide 62: In Summary
In Summary 62 Proprietary and Confidential Property of Accuray Entering FY22 With Accelerating Momentum Strongest Product Portfolio and Pipeline in Company’s History Multiple Growth Catalysts and Global Commercial Execution Strengthened Leadership Team and Operational Foundation Positioned for Accel
Slide 63: Q&A
63 Proprietary and Confidential Property of Accuray Q&A
Slide 64: Thank you
64 Proprietary and Confidential Property of Accuray Thank you
Slide 65: Appendix
Appendix
Slide 66: GAAP to Adjusted EBITDA FY21 Actual
66 Proprietary and Confidential Property of Accuray GAAP to Adjusted EBITDA FY21 Actual Reconciliation of Net Income (Loss) to Adjusted Earnings Before Interest, Taxes, Depreciation, Amortization and Stock-Based Compensation (Adjusted EBITDA) (a) consists of one-time charge related to the exchange o
Slide 67: GAAP to Adjusted EBITDA Q1 Preliminary and FY22 Projected Guidance
67 Proprietary and Confidential Property of Accuray GAAP to Adjusted EBITDA Q1 Preliminary and FY22 Projected Guidance Projected Guidance Reconciliation of Net Income (Loss) to Adjusted Earnings Before Interest, Taxes, Depreciation, Amortization and Stock-Based Compensation (Adjusted EBITDA)
Slide 68: GAAP to Adjusted EBITDA FY19 Actual
68 Proprietary and Confidential Property of Accuray GAAP to Adjusted EBITDA FY19 Actual Reconciliation of Net Income (Loss) to Adjusted Earnings Before Interest, Taxes, Depreciation, Amortization and Stock-Based Compensation (Adjusted EBITDA) (a) consists of an accounts receivable impairment charge